The Care Quality Commission
  • Ambulance service

Archived: SSG UK Specialist Ambulance Service - North

Overall: Requires improvement read more about inspection ratings

Admiral Business Park, Cramlington, Northumberland, NE23 1WG (01670) 719471

Provided and run by:
SSG UK Specialist Ambulance Service Ltd

All Inspections

30 April 2019

During a routine inspection

SSG UK Specialist Ambulance Service North is operated by SSG UK Specialist Ambulance Service Ltd (SSG) . The service provides a patient transport service for patients with mental ill health.

We inspected this service using our comprehensive inspection methodology. We made an unannounced visit to the service on 30 April 2019.

The service had been previously inspected in April 2018 but not rated.

Following that inspection, we told the provider that it must take three actions to comply with the regulations and that it should make six other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice that affected Patient Transport.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

The main service provided by this service was patient transport.

We rated it as  requires improvement overall.

We found the following issues that the service provider needs to improve:

  • During the previous inspection the provider was given six should do actions to improve the service. During this inspection we found four of the six should do actions had not been completed.

  • The provider did not have their own procedure for identifying high risk/infectious patients.

  • During the inspection we found limited evidence the provider carried out effective audits to measure the quality and effectiveness of the service delivered. This was because the number of observations or gathering of audit information was so low; they were not a representative sample of the number of staff employed or the number of patient transports undertaken.

  • The provider did not actively seek feedback about the quality of care and overall service provided.

  • There was no evidence that dynamic risk assessments in relation to patients were recorded.

  • There was not a system to record or measure the levels of staff adherence to local policies and procedures.

  • There were very limited supervisory operational observations of staff carried out to identify either good or poor practice.

  • During this inspection there was no evidence the PTS vehicles we inspected carried any information or leaflets which would explain to a patient, relative or carer how to make a complaint.

  • During the inspection we did not see evidence of an effective system to actively seek feedback from patients, those lawfully acting on their behalf, their carers and others such as staff or other relevant bodies.

However, we found the following areas of good practice:

  • During this inspection we saw evidence the provider had acted to deal with the three must do actions, two of the six should do actions and the requirement notice issued following the previous inspection.

  • There was evidence of a formal system for reporting and responding to incidents.

  • There were high levels of staff statutory and mandatory training.

  • The station and working environment were visibly clean, safe and fit for purpose.

  • There was evidence during this inspection that the five employed staff had a current appraisal.

  • Staff observed during inspection displaying a caring, empathetic and supportive attitude.

  • Staff were observed working well with hospital staff to calm a patient who was refusing to be transported.

  • Patient transport journeys were planned to take account of patient risk.

  • There was a shift system to manage access and flow covering 24 hours per day.

  • There was evidence of a provider mission statement, values and strategic priorities for 2019.

  • There was evidence of recent 1:1 staff employment consultation in relation to increasing the number employed staff in the company.

Following this inspection, we told the provider that it must take six actions to comply with the regulations and that it should make 12 other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with three requirement notices that affected Patient Transport Services. Details are at the end of the report.

Ann Ford Deputy Chief Inspector of Hospitals (North), on behalf of the Chief Inspector of Hospitals

11 April 2018

During an inspection looking at part of the service

SSG UK Specialist Ambulance Service North is operated by SSG UK Specialist Ambulance Service Ltd (SSG). The service provides a patient transport service (PTS) for patients with mental ill health. They also provide medical first aid support at public and private events.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 11 April 2018.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

The main service provided by this service was transporting patients with mental ill health.

Services we do not rate

We regulate independent ambulance services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

We found the following areas of good practice:

  • Managers and operational staff were aware of the application of duty of candour and could give examples where it should be used, as well the requirement to be open and honest.
  • There was detailed infection prevention and control (IPC) policy and staff were aware of their responsibilities in relation to this.
  • PTS drivers had a current Business and Technology Education Council (BTEC) Level three advanced driver qualification and their eligibility to drive vehicles was checked prior to employment and on an ongoing basis.
  • The staff mandatory training compliance rate at the time of the inspection was 87.5 %
  • The provider`s policies were based on National Institute of Care and Excellence (NICE) Joint Royal Colleges Ambulance Liaison Committee (JRCALC) clinical practice guidelines.
  • Staff could explain the implications of the Mental Capacity Act 2005 and Deprivation of Liberty Standards in relation to patient consent and to record any issues on the transport booking form.
  • Staff could describe how they would take steps to try and minimise distress in patients and families.
  • There was positive feedback from patients.
  • Staff could outline how they would deal with patients with complex needs.
  • Managers planned patient transport based on risk to ensure people’s individual needs were met.
  • Regular monthly staff forum meetings were held where staff could raise issues.
  • The provider had a well-managed extensive risk register.

However, we also found the following issues that the service provider needs to improve:

  • No staff appraisals had been completed since the company commenced providing PTS in July 2017, however, at the time of the inspection the provider was within the 12 month period for completing staff appraisals.
  • The provider did not record any observation or audits of staff handwashing.
  • The PTS ambulances did not carry any information regarding how a patient, carer or relative could make a complaint or provide feedback about the service.
  • Dynamic risk assessments carried out by SSG staff in relation to handcuffing patients were not recorded.
  • There was no site specific business continuity plan for the Cramlington building.
  • The provider did not have a site specific risk register.

Following this inspection we identified one regulatory breach and six areas where the provider should improve, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Ellen Armistead

Deputy Chief Inspector of Hospitals, on behalf of the Chief Inspector of Hospitals